Date of Award
Spring 5-24-2025
Document Type
Doctor of Nursing Practice Final Manuscript
Degree Name
Doctor of Nursing Practice
Department
Nursing
First Advisor
Martha G. Fuller, PhD, PPCNP-BC
Abstract
Introduction: This evidence-based practice project implemented and evaluated the One Key Question® (OKQ) screening tool to improve pregnancy intention screening and reproductive health counseling in primary care. The goal was to better identify reproductive health needs among women of reproductive age and enhance provider engagement in preconception and contraceptive counseling.
Background: Nearly half of all pregnancies in the U.S. are unintended, and many women do not receive timely reproductive health counseling. Despite national recommendations, pregnancy intention screening is often missed in primary care. Early identification of reproductive goals supports better outcomes through tailored education, contraception, or preconception care. OKQ is a validated, patient-centered tool designed to normalize and guide these conversations.
Methods: This quality improvement project took place at a Federally Qualified Health Center in Southern California using a pre-post-intervention design. Medical assistants administered a paper-based OKQ screening during annual physicals, and providers used responses to guide counseling. Data were collected from electronic health records before and after implementation.
Results: Before implementation, 37% of patients were screened for pregnancy intention and 37% received counseling. After implementation, 100% were screened and 68% received counseling, reflecting a 31% improvement. This increase was statistically significant (p = 0.031). Follow-up scheduling improved by 17%, though not statistically significant (p = 0.245).
Evaluation: The project significantly improved reproductive health screening and counseling. OKQ was successfully integrated into routine care with minimal disruption. Ongoing efforts should focus on expanding staff involvement, integrating the tool into the electronic health record, and applying screening to all visit types.
Digital USD Citation
Adams, Laura D., "Implementation of One Key Question® Screening Tool to Increase Reproductive Life Planning at a Community Health Clinic" (2025). Doctor of Nursing Practice Final Manuscripts. 312.
https://digital.sandiego.edu/dnp/312
Copyright
Copyright held by the author
